Individual
DR. SUZANNE WILLARD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1427 VINE ST, 3RD FLR, PHILADELPHIA, PA 19102-1031
(215) 762-2530
(215) 762-2531
Mailing address
6123 WAYNE AVE, PHILADELPHIA, PA 19144-6103
(215) 768-0337
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
VP001737C
PA
Other
Enumeration date
06/15/2006
Last updated
07/08/2007
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